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Vision Coverage

Learn which vision benefits our individual plans cover and what benefits you can get by buying additional coverage.

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Add dental coverage to your new or existing plan.

What You Get with Your Plan

Under the Affordable Care Act, any member 18 years and under gets vision care at no extra cost. Adults who are 19 and older are covered for a yearly eye exam.

  • Individual and Family Plans
    Adult Vision Exam
    once every 12 months
    Pediatric Vision Exam
    once every 12 months
    Pediatric Vision Materials*
    includes frames and lenses, or contacts once every 12 months
    Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider
    2021 POS HSA 6900 Elite Bronze Deductible, 0% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS 1000 Elite Gold
    2021 POS 2500 Elite Gold
    2021 POS 3000 Elite Silver
    2021 POS 4200 Elite Silver
    2021 POS 5000 Elite Silver
    2021 POS 6000 Elite Bronze
    2021 POS 6500 Elite Bronze
    2021 POS 7000 Elite Silver
    2021 POS 7250 Elite Silver
    $20 per exam Not Covered $0 per exam Deductible, 50% $0 per item In Network Benefit Applies
    2021 POS 8000 Elite Bronze Deductible, 50% Not Covered $0 per exam Deductible, 50% $0 per item In Network Benefit Applies
    2021 HMO 8550 Elite Catastrophic Deductible, 0% Not Covered $0 per exam Not Covered $0 per item Not Covered
    Adult Vision Exam
    once every 12 months
    Pediatric Vision Exam
    once every 12 months
    Pediatric Vision Materials*
    includes frames and lenses, or contacts once every 12 months
    Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider
    2021 HANW IND POS 2000 Gold $20 per exam Not Covered $0 per exam Dedutible, 50% $0 per item In Network Benefit Applies
    2021 HANW IND Summit 5750 Silver $20 per exam Not Covered $0 per exam Not Covered $0 per item Not Covered
    2021 HANW IND Summit HSA 6650 Bronze Deductible, 10% Not Covered $0 per exam Not Covered Deductible, $0 per item Not Covered
  • Small Group Plans
    Adult Vision Exam
    once every 12 months
    Pediatric Vision Exam
    once every 12 months
    Pediatric Vision Materials*
    includes frames and lenses, or contacts once every 12 months
    Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider
    2021 POS HSA 2000 Gold
    2021 POS HSA 6500 Bronze
    Deductible, 0% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS HSA 2800 Gold
    2021 PPO HSA 2800 Gold
    Deductible, 10% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS HSA 3500 Silver Deductible, 15% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS HSA 5000 Silver
    2021 PPO HSA 5000 Silver
    Deductible, 20% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS 1500 Gold
    2021 POS 2000 Gold
    2021 POS 2500 Gold
    2021 POS 3000 Gold
    2021 POS 3500 Gold
    2021 POS 3800 Silver
    2021 POS 5500 Silver
    2021 POS-C 2800 Silver
    2021 PPO 1500 Gold
    2021 PPO 3500 Gold
    2021 PPO 3800 Silver
    $20 per exam Not Covered $0 per exam Deductible, 50% $0 per item In Network Benefit Applies
    2021 HMO 1000 Gold
    2021 HMO 2000 Gold
    2021 HMO 2500 Gold
    2021 HMO 500 Platinum
    2021 HMO 6500 Silver
    $20 per exam Not Covered $0 per exam Not Covered $0 per item Not Covered
    Adult Vision Exam
    once every 12 months
    Pediatric Vision Exam
    once every 12 months
    Pediatric Vision Materials*
    includes frames and lenses, or contacts once every 12 months
    Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider
    2021 POS HSA 2000 Gold
    2021 POS HSA 6500 Bronze
    Deductible, 0% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS HSA 2800 Gold Deductible, 10% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS HSA 3500 Silver Deductible, 15% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS HSA 5000 Silver Deductible, 20% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 POS 1500 Gold
    2021 POS 2000 Gold
    2021 POS 2500 Gold
    2021 POS 3000 Gold
    2021 POS 3500 Gold
    2021 POS 3800 Silver
    2021 POS 5500 Silver
    2021 POS-C 2800 Silver
    $20 per exam Not Covered $0 per exam Deductible, 50% $0 per item In Network Benefit Applies
    2021 HMO 1000 Gold
    2021 HMO 2000 Gold
    2021 HMO 2500 Gold
    2021 HMO 500 Platinum
    2021 HMO 6500 Silver
    $20 per exam Not Covered $0 per exam Not Covered $0 per item Not Covered
    Adult Vision Exam
    once every 12 months
    Pediatric Vision Exam
    once every 12 months
    Pediatric Vision Materials*
    includes frames and lenses, or contacts once every 12 months
    Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider Preferred Provider Non-Preferred Provider
    2021 HANW POS HSA 6850 Bronze Deductible, 0% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 HANW POS HSA 5000 Silver Deductible, 10% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 HANW POS HSA 3000 Silver Deductible, 20% Not Covered $0 per exam Deductible, 50% Deductible, $0 per item In Network Benefit Applies
    2021 HANW POS 1000 Gold
    2021 HANW POS 1500 Gold
    2021 HANW POS 2000 Gold
    2021 HANW POS 3000 Gold
    2021 HANW POS 4600 Silver
    $20 per exam Not Covered $0 per exam Deductible, 50% $0 per item In Network Benefit Applies
    Adult Vision Exam
    once every 12 months
    Pediatric Vision Exam
    once every 12 months
    Pediatric Vision Materials*
    includes frames and lenses, or contacts once every 12 months
    Preferred Provider Non-Preferred Provider Tier 1 Preferred Provider Non-Preferred Provider Tier 1 Preferred Provider Non-Preferred Provider Tier 1
    2021 Simplete Memorial HMO 4000 HSA Silver Deductible, 30% Not Covered Deductible, 20% $0 per exam Not Covered $0 per exam Deductible, $0 per item Not Covered Deductible, $0 per item
    2021 Simplete Memorial HMO 6500 HSA Bronze Deductible, 50% Not Covered Deductible, 40% $0 per exam Not Covered $0 per exam Deductible, $0 per item Not Covered Deductible, $0 per item
    2021 Simplete Memorial POS 1000 Platinum
    2021 Simplete Memorial POS 1500 Gold
    2021 Simplete Memorial POS 3000 Gold
    2021 Simplete Memorial POS 3850 Silver
    $20 per exam Not Covered $20 per exam $0 per exam Deductible, 50% $0 per exam $0 per item $0 per item $0 per item
    2021 Simplete Memorial POS 6000 Bronze Deductible, 50% Not Covered Deductible, 35% $0 per exam Deductible, 50% $0 per exam $0 per item $0 per item $0 per item
    2021 Simplete Memorial HMO 2500 Gold
    2021 Simplete Memorial HMO 500 Platinum
    $20 per exam Not Covered $20 per exam $0 per exam Not Covered $0 per exam $0 per item Not Covered $0 per item
  • Extra Vision Coverage You Can Buy

    You can also buy extra vision benefits from VSP for your individual plan. Their strong network of doctors covers more than 56 million members across the country.

    With these extras, everyone on your plan 19 years and older gets:

    • An eye exam
    • Unlimited discounts on:
      • Glasses lenses
      • Glasses frames
      • Contact lenses
      • Laser surgery

    All this costs just $3.91 per month per person. There's also no deductible and a $130 allowance for frames and contact lenses.

    Find a Provider

     

    Search VSP

    *Members can choose any provider for vision materials. We cover material costs up to our maximum allowable cost. If a provider bills at more than maximum allowable cost, members are responsible for paying the difference.

    WellVision Exam® Thorough Eye Exam Covered in Full* Once Every 12 Months
    Lenses
    • Glass or plastic, single-vision, lined bifocal, lined trifocal lenses covered in full*
    • 20% off all non-covered lens options
    • 20% off additional pairs of prescription glasses (unlimited)
    • 20% off non-prescription sunglasses (unlimited)
    Frames
    • Frames covered in full* up to the retail allowance of $130 for a wide selection of frames
    • 20% off any amount above the $130 allowance (once every 12 months)
    Contact Lenses
    • 15% off contact lens services (excluding materials)
    • Instead of eyeglasses, elective contact lens services and materials covered up to $130 toward any type of prescription contact lenses
    • Necessary contact lenses covered in full* for members who have a specific condition for which contact lenses provide better sight correction
    Laser VisionCare Program
    • VSP-contracted laser centers provide discounts for laser surgery including PRK, LASIK, and Custom LASIK**
    • Discounts average 15% off or 5% off if the laser center offers a promotional price***

    *Except for any applicable copayment, including a $20 copayment for the exam. There is no separate copayment for lenses, frames, or contacts.
    **Custom LASIK coverage only available using wavefront technology with the microkeratome surgical device. Other LASIK procedures may be performed at an additional cost to the member.
    ***Laser VisionCare discounts are only available from VSP-contracted facilities. Preauthorization required.

     

    For details on specific vision services and limits, see your plan's policy (under Vision Care).